title: Vulnerable self, poor understanding of others' minds, threat anticipation and cognitive biases as triggers for delusional experience in schizophrenia: a theoretical model.
abstract: It remains unclear what processes lead to the establishment of persecutory delusions in acute phases of schizophrenia. Recently, it has been argued that persecutory delusions arise from an interaction among a range of emotional, cognitive and social factors. In this work, we explored this possibility by first discussing the relevant aspects of recent theoretical models of the causes of persecutory delusions. Then, we offered an analysis of the literature, illustrated with clinical observations suggesting that persecutory delusions are triggered during stressful intersubjective transactions by the interactions of (a) an alteration in empathetic perspective taking and in pragmatic understanding of others' minds; (b) a perception/representation of the self as vulnerable or subordinate and of the other as dominant and threatening; and (c) a hyperfunctioning of the threat/self-protection system when faced with perceived danger. Implications for future research and treatment of people suffering from this symptom are discussed.
authors.affiliation: Third Center of Cognitive Psychotherapy-Associazione di Psicologia Cognitiva-APC, Rome, Italy. giampaolosalvatore@virgilio.it
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Salvatore
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
authors.forename: Raffaele
authors.initials: R
authors.lastname: Popolo
authors.forename: Michele
authors.initials: M
authors.lastname: Procacci
authors.forename: Antonino
authors.initials: A
authors.lastname: Carcione
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Dimaggio
mesh_terms: D000374:Aggression / Q000523:psychology; D003071:Cognition; D003702:Delusions / Q000523:psychology*; D004532:Ego; D006801:Humans; D008960:Models, Psychological; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012649:Self Concept; D056345:Theory of Mind